All preventable deaths should be prevented - this is the gold standard. In reality, of course, things don't work out that way. The analogy with a flu season is deeply misleading. The coronavirus has, in half a year, killed more people than the worst flu seasons, with extraordinary measures in place all over the world. It's completely reasonable to assume that without lockdowns we would have had millions of deaths already.
> The reality is that everyone is prepared to allow others to die for their own convenience.
It may be so. Those people are morally wrong however. This is a deep point that I have insisted on in other comments as well. Casually weighing human life against economic cost is not acceptable in what we might call a civilized society.
> The only difference between believing 70,000 is okay, and 700,000 is not is a gut feeling about how much preventable death is worth it to maintain our living standards.
That is not true. Deaths caused by the regular flu are deeply regrettable and should be prevented as much as possible. If you dig into the data however, you will see that the coronavirus not only kills many more people than the flu, but it also kills people who would otherwise have many more years left to live. Diabetes, a heart condition or age > 65 yrs. shouldn't be death sentences in a modern civilized society.
> Casually weighing human life against economic cost is not acceptable in what we might call a civilized society.
The reality is quite different. We accept a risk of death to ourselves and others in everything we do. You do it, too. Everything. You even risk death by doing nothing.
You could say "if it cost $1b to save this life, we should do it". But how many lives could be saved at $1b each before we run out of money? Then what? And what about the lives that could have been saved at $1m apiece?
If someone not willing to give up all of his assets to save someone else's life, is he uncivilized and morally wrong?
> You could say "if it cost $1b to save this life, we should do it".
This a common, yet unrealistic, hypothetical. In reality, of course, death is inevitable regardless of the economic costs. Past a certain point everybody, so far, has died. The amount of things that we can do in order to prevent any given death doesn't scale with the economic cost, past a certain (quite low) point. Spending 1B on a person won't get you 1000 times better 'medical stuff' than spending 1 million; therefore, a trade-off of e.g. one life for 1B vs 1000 lives for 1m is illusory.
In practice all societies have limited resources. My position is, however, that those limited resources, in the case of an acute health crisis, should be focused as much as possible on mitigating that crisis, without having primary concern for the economic costs.
> All preventable deaths should be prevented - this is the gold standard.
It absolutely isn't; it is complete nonsense.
Firstly, it directly conflicts with right to die; it asserts that if we can intervene in any suicide, then we should. How can stepping on the right to die be elevated to a gold standard?
Some people take risks, and those risks are fatal. Deaths in dangerous sports and other activities are easily preventable: just forcibly take away the right to engage in them. Closing off Mt. Everest to climbers will certainly prevent deaths. By your gold standard, that must be what should be done.
Preventing some deaths may even require lives to to be imperiled; someone has to be asked to risk their own life to save others.
No, no, no; live and let die is the gold standard.
People should be sometimes left to the consequences of their actions and circumstances and that includes dying. Obviously not always, and not as a rule, but sometimes. Often enough that "all preventable deaths should be prevented" is utterly preposterous.
There is no right to die in most countries in the world. Got horrible painfull and untreatable disease, but a few years left on the clock? In most places you are doomed to suffer through it. The only exception i am aware of is netherlands.
Secondly, most of your post conflates me engangering myself my choice ( i choose a dangerous sport and suffer) vs someone else endangering me (unsafe building collapses on my head).
Note that, normally, a writer can't conflate A and B, if they don't make even the slightest reference to B. That said, I've pulled off "the impossible" before.
It may be so. Those people are morally wrong however.
I'm willing to bet that you have taken many unnecessary car trips in your life. By doing so you have increased the risk to other drivers, cyclists, and pedestrians of suffering a fatal accident. Sure, it's a very small increase, but surely that outweighs your selfish desire to visit your friends or go to a movie.
Casually weighing human life against economic cost is not acceptable in what we might call a civilized society.
It's not only acceptable, it's essential in order to make reasonable decisions.
Deaths caused by the regular flu are deeply regrettable and should be prevented as much as possible.
Flu vaccine reduces risk of death. Coronavirus has no vaccine yet. I do think we take the flu too lightly. Urgent care and hospitals definitely need to be more risk averse even after this pandemic is over, and I hope we learn that lesson in this pandemic.
To my knowledge all modern nation states have some sort of stat like that; it’s either relevant for healthcare expense planning, or disability/life insurance schemes. I believe the US rates it down to the value of each limb for the latter; and my private AD&D insurance does the same.
The response to the coronavirus has been many orders of magnitude more strict than the response to the flu. All this while be less than an order of magnitude as deadly, probably 3X-4X. This is why I think it is perfectly valid to compare it to the flu.
The collective response has been outsized to the actual risk of death, and I believe this is due to fear rather than sensible policymaking.
If it really was about reducing all cause mortality, most governments could do so much to reduce the primary causes of death, like heart disease and cancer, by banning things like cigarettes and enforcing healthier diets among the populace.
Imagine what banning sugar alone would do to the rates of obesity and type 2 diabetes in the US. But no one wants to do that.
> All preventable deaths should be prevented - this is the gold standard. In reality, of course, things don't work out that way.
Yes, in reality a lot of people die driving cars all around the world no matter the amount of on board safety devices and yet cars are legal everywhere. There are countless similar examples.
Preventable is what people agree or tolerate to prevent.
Really? Here in Norway children would only be vaccinated against influenza if they already have other severe conditions such as diabetes, chronic heart or lung disease, etc.
First, economy was never a consideration for the Swedish Corona strategi.
Secondly, the flue has quite reason, like year 2000, taken more lifes in Sweden then what Corona has taken this year. And I would be surprised if that would be exceptional to Sweden.
That not even consider there are more people living in Sweden today then 20 years ago. A couple of years earlier, the death rate per 100 000 was higher then Corona this spring.
And yes, there are some strong indications that there was Corona in Sweden in December, in Svärdsjö, Dalecarlia. A woman that has not been outside of the region got Corona signs on X rays of her lungs.
And that I guess isn't exceptional either. So, we probably hade Covid-19 a lot earlier than we has thought. Which could explain the explosion of the spread.
> Casually weighing human life against economic cost is not acceptable in what we might call a civilized society.
Human life and economic cost are not separate things. The economy is a comprehensive (if incomplete) description human life. When we shut down the economy we cause millions to lose jobs, to lose incomes, to lose structure, to lose community, to lose activities that give their lives purpose and joy.
The economic shut down is killing people. It's also reducing quality of life and length of life. That's not to say it's not worth it. The effects of lockdown are hard to measure and no one can be sure if it's worth it or not. But this framing of economic cost vs human life as if it's just a little money is wildly inaccurate and damaging.
> It's completely reasonable to assume that without lockdowns we would have had millions of deaths already.
I agree that it's a reasonable assumption. Ivor Cummings dives into some statistics a bit more, and it isn't so clear that the lockdown had the effect, rather that it might be do to with seasonality and the way the virus spreads. I am interested if anyone has any decent criticism of the numbers he bring up in that video, as they seemed reasonable to me?
> The coronavirus has, in half a year, killed more people than the worst flu seasons
That's not true. The flu seasons in 1968, 1957, 1918, and 1889 each killed over a million people worldwide, twice as many as COVID-19 in roughly the same timespan, and that out of a lower total population, and despite lockdowns and quarantines.
(Who is downvoting this simple truth? How is anyone going to discuss this issue if we can't even talk about basic facts?)
You are referring, I think, to years with pandemics that were not caused by what can be called the 'regular' flu. It's especially comical that you have included the 1918 flu pandemic among your counter-examples.
At least for Sweden, it is still true that the worst flus have killed more people than corona on a per capita basis. And we don't have to go back very far at all to find cases of this. 1993 and 2000 where particularly bad and topped corona.
But that is corona with social distancing and very widespread working from home, so it isn't really an apples to apples comparison.
What is "regular" flu? There are many strains in circulation, including those that caused past pandemics. We have vaccines and acquired immunity, so it's been some time since the last truly deadly flu epidemic, but the flu should not be dismissed so lightly.
And why wouldn't I include 1918 in a list of flu pandemics that killed over a million people?
Is it? I see it acknowledged, and often paired with the observation that the worst flus have not been mitigated by extreme social distancing as we have now.
Let's look at British Columbia, Canada where we have managed to stabilize at ~10 cases a day. How long before we get the same number of deaths with our population of 5 million people. Hmm, 5 million divided by 10 divided by 365 is 1369 years. Even if we consider 10 cases for every one detected case that's ~137 years! Longer than a human life span. Ignoring things like improved treatment options, vaccines, and other things that are going to change in our understanding.
So I think this proves the argument wrong.
If you consider the other costs you're avoiding, long term issues for sick people, the cost of treating all these people in hospital, the potential for people to get sick with this multiple times (we don't know if you get any immunity by getting sick) then it's even clearer.
They have only stabilized at that level if you are willing to permanently keep things the way they are. Are you comfortable with the restrictions currently in place being permanent?
I think we can keep things where they are. The current restrictions aren't great but they are sustainable:
- Virtually no travel in and out of the country (goods still flow though).
- No gatherings > 50 people.
- Keep 2m away from others (except for "bubbles").
- Wash your hands.
- Masks in certain situations (not mandatory for most).
- Various limitations in place as to how businesses operate, e.g. distance between tables in restaurants, physical barriers, cleaning, one way aisles in stores etc etc.
Since I'm not the type or age who goes partying out in crowded bars or to packed concerts that stuff doesn't really bother me personally. Sure, it's no fun, but the alternative seems like a lot less fun. In my (global) company we all switched to wfh when this started and I'm fine with that.
Wow. All I can say is that you have very different priorities than most others. Most are ok with those changes temporarily. Almost nobody is willing to make that sacrifice permanently.
Permanently != until there's a vaccine or effective treatment.
There's lot of room for optimization/improvements. Travel might be ok to locations that have this under control, for example. We might find better solutions for keeping the transmission low. We could decide to clamp down harder and eradicate the virus locally so that we can trade off local restrictions vs. travel restrictions.
It's just between all the bad options here this seems to be the least bad. 2 years of the disease raging through the community until (maybe) there's herd immunity sounds so much worse. I'm pretty sure the Americans who think this is the way to go will change their minds come this fall assuming the current trend continues. Maybe I'm wrong... Let's catch up in December ;)
> Youre are going to have the same number of deaths sooner or later as long as the hospitals aren't overwhelmed.
Even assuming there's never a vaccine or effective cure, this is not true: temporarily reducing the R number (lockdowns, distancing, masks) reduces the overshoot in the total number of people who get the disease (some proportion of which will die). It's the difference between scenario 0 and scenario 1 in the excellent https://ncase.me/covid-19/ playable models.
Quoting the site: "This reduces total cases! Even if you don't get R < 1, reducing R still saves lives, by reducing the 'overshoot' above herd immunity. Lots of folks think "Flatten The Curve" spreads out cases without reducing the total. This is impossible in any Epidemiology 101 model. But because the news reported "80%+ will be infected" as inevitable, folks thought total cases will be the same no matter what. Sigh."
What I said: "temporarily reducing the R number (lockdowns, distancing, masks) reduces the overshoot in the total number of people who get the disease (some proportion of which will die)."
The R is reduced while any effective measures are active. The playable sim for Scenario 1 has them active while there's blue shading over the graph, deactivating them once herd immunity is reached in that sim. In that case, compared to scenario 0 (do nothing), fewer people have been exposed so fewer people die. So it is not true to say, as you did, that "Youre are going to have the same number of deaths sooner or later as long as the hospitals aren't overwhelmed."
> There's no avoiding society returning to normal as people need jobs to pay rent and buy food.
You've moved the goalposts, but even so, the later sims suggest other things that can be done with less invasive measures like test and trace, wearing masks and social distancing. These don't prevent people doing jobs. They do decrease the number of people who die.
What's a preventable death? Everybody dies eventually, there's no such thing as a preventable death. There's delaying death, but everyone dies. Period.
I feel that in this thread people are quite stubborn about interpreting things literally, or misinterpreting them all together.
I will give it my best shot at clarifying:
Preventable refers to what a given society can be expected to manage given its limited resources and given other moral constraints, such as not impinging on people's freedoms unnecessarily. A number of the terms I have used have vague meanings that can't be clarified (not by me at least) within the scope of an HN comment. A good faith interpretation of my statement would be that a society should hold saving lives as its highest priority, as long as this does not cause catastrophic costs or dystopian levels of population control. Some temporary economic costs and some temporary restrictions on certain freedoms should be accepted, I think.
> in this thread people are quite stubborn about interpreting things literally, or misinterpreting them all together.
My complaint is a bit different. I'd say "preventable deaths should be prevented" and people will interpret that as if it said "all". I reply that if I meant "all" I would have said "all".
Your case is a bit different, because you said "all" but did not mean "all".
> The reality is that everyone is prepared to allow others to die for their own convenience.
It may be so. Those people are morally wrong however. This is a deep point that I have insisted on in other comments as well. Casually weighing human life against economic cost is not acceptable in what we might call a civilized society.
> The only difference between believing 70,000 is okay, and 700,000 is not is a gut feeling about how much preventable death is worth it to maintain our living standards.
That is not true. Deaths caused by the regular flu are deeply regrettable and should be prevented as much as possible. If you dig into the data however, you will see that the coronavirus not only kills many more people than the flu, but it also kills people who would otherwise have many more years left to live. Diabetes, a heart condition or age > 65 yrs. shouldn't be death sentences in a modern civilized society.